Coxiella burnetii (Q fever)
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Coxiella burnetii
- Characteristics
- Gram negative coccobacilli
- obligate intracellular
- Transmission
- Inhalation of aerosolized spores
- Seen in occupational exposures to farm animals
- From placental or amniotic fluid of livestock
- Humans are incidental hosts (not natural carriers)
- Presentation: Q fever
- Flu-like symptoms (fever, headache)
- mild pneumonia
- hepatitis
- Elevated ALT and AST
- May cause culture-negative endocarditis
- Diagnosis
- Usually clinical; although may be supplemented with testing
- Blood cultures usually negative
- Immunofluorescence assay for IgG against Coxiella is used to confirm diagnosis
- Treatment
- Doxycycline is first-line
- TMP-SMX given if doxycycline is not tolerated
- Hydroxychloroquine may be added with cardiac involvement
- Doxycycline is first-line